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CYBERPHYSIOLOGY: cyber from the Greek root kybernan, "to steer," from which is derived
kybernet(es), meaning "the helmsman." From the Latin form comes the English, "gubernatorial."
But the possibility that consciousness could be trained to alter involuntary bodily
processes has only recently become an area of systematic investigation, alternately
referred to as behavioral medicine or as the voluntary control of internal states. Earl
Bakken, bioengineer and founder of Medtronic, Inc., in Minneapolis, has proposed the
new terms cyberbiology and cyberphysiology, which serve to bring a growing number of
research efforts under a single rubric that denotes the reciprocal effects of consciousness
and physiology.
Cyberphysiology is the study of how
neurally mediated autonomic
responses, usually viewed as reactive
reflexes, can be modified by a learning
process that appears to be significantly
dependent on image design or figures
of thought. That is, simple instruction
in physical relaxation techniques,
coupled with awareness of breathing
patterns, and the use of a person's
capacity for inner visualization, appear
to be the prerequisite ingredients for
the motivated subject to induce a state
of heightened, inwardly directed
awareness that can lead to either direct
or indirect control of physiological
processes.
THE PROBABLE PATHWAY OF
ACTION
The way in which human beings form
images in the brain is not well
understood, partly because imagery is
not localized in only one site, and
imagining also involves numerous associative processes. Studies in hemispheric
lateralization, for instance, show that the left hemisphere is dominant for calculation and
language, while the right hemisphere is dominant for spatial construction, simple
language comprehension, and nonverbal ideation. Numerous authors have suggested that
imagery may be mediated by the right hemisphere, but the left must play some role in the
process. Experimental evidence shows, for instance, that it mediates such functions as
size discrimination, when such differences in images must be stored and called forth for
use at a later time.
On the other hand, brain lesion studies support the contention that not only nonverbal
images but also body image may be right hemisphere dominant. For instance, lesions in
the right parietal lobe result in a syndrome in which the patient may fail to recognize part
of the body, denying it to the extent that it may not be washed, covered, or otherwise
cared for. Also, lobectomies, performed on patients in past decades for severe psychiatric
disorders, implicated the right frontal cortex as one probable area where mental images
might be dominant. Patients who underwent this procedure not only lacked emotional
reactivity and motivation, but also showed disruption of the temporal ordering of events
and seemed unable to fantasize or imagine a future. In particular, they showed complete
loss of ability for delayed action, in which an interim picture must be held in the mind.
In addition to mental imagery, motivation and emotion have been related to
neurochemical processing in the frontal lobes. Through many known fibers, the frontal
lobes have projections into the limbic system, which is considered the subcortical area for
emotional integration. Indeed, some researchers refer to the frontolimbic system as the
principal neurochemical mediating center of emotions.
While there is some debate as to the precise structures that should be included in the
limbic system, the amygdala, hippocampus, septal area, and cingulate cortex are usually
included. The limbic system has been associated experimentally with the sense of smell,
the experience of pleasure and pain (and hence with reward and punishment), social
interaction, and even violent behavior.
Typically, the hypothalamus is singled out as a separate system of sorts that is only partly
involved in limbic activation, but functionally, many, if not all, of the effects produced by
stimulation or lesions in the other limbic structures can be attained by similar operations
on the hypothalamus itself. The hypothalamus is implicated in the physiology of
All of these reactions have been biologically useful for survival, but modern research has
found that prolonged activation of the stress response, especially in the absence of
physical outlets, such as vigorous physical exercise or the actual conditions of battle, may
lead to a variety of ailments, from chronic indigestion, ulcers, and high blood pressure, to
a buildup of cholesterol, aggravation of diabetes, and lowered immune functioning. Hans
Selye identified an adaptation syndrome of ever-increasing compensation for prolonged
stress that culminates in the death of the organism. It is also known that extreme and
violent shock from fright can, through this axis, lead to such phenomena as sudden
cardiac arrest, which Cannon and Alvarez described as the likely cause of voodoo death.
THE RELAXATION RESPONSE
By the employment of readily available cyberphysiologic techniques, a trained lowering
of arousal, on the other hand, has been experimentally associated with restoration of
homeostatic balance and renewed health and vigor. Herbert Benson, a cardiologist who is
head of the Behavioral Medicine Section at Harvard Medical School and the Deaconess
Hospital in Boston, has identified what he believes is a physiological template common
to almost all such techniques that he calls the relaxation response, an integrated
hypothalamic activity resulting in generalized decreased sympathetic nervous system
firing, with possible parasympathetic activation.
He has defined four elements needed to elicit this response: (1) a sound, word, or phrase
that can be constantly repeated in the mind; (2) a passive attitude; (3) decreased muscle
tonus; and (4) a quiet environment. Practice of the relaxation response for only 20
minutes a day decreases oxygen consumption and carbon dioxide elimination, without
changing respiratory quotient; it decreases blood pressure; it also decreases blood lactate
(a change associated with lowered stress); and increases the intensity of slow alpha
waves, which are associated with restful alertness.
Ischemic heart patients taught this technique show a decrease in premature ventricular
contractions. Patients suffering from hypertension who learn the relaxation response
require much less medication than usual. In normal subjects, it may actually be a
prophylactic measure against hypertension. Perhaps most significant, patients in a health
maintenance organization who were taught the relaxation response had faster recovery
from illnesses and incurred lower costs than a comparable control group simply given
regular medical treatment.
Benson maintains that the physiological effects of the relaxation response are generic to a
wide range of techniques taught by the world's contemplative religious traditions, which
elicit the same underlying physiological responses as a first step in systematic spiritual
practice. He accounts for the dramatic differences that the various techniques produce by
the differences in cognitive context, which determine the direction physiological
reactions will take by the particular cognitive goal described in the different philosophies.
Hence, he concludes, the individual's consensually shared world of meanings, beliefs, and
values, play a major role in the long-term outcome of such practice.
He believes that the relaxation response is also the basic template for a wide range of
cyberphysiologic techniques currently of interest to behavioral medicine, including
hypnosis, biofeedback, yoga, and meditation. The relaxation response may also be the
generic first step toward the eventual experimental regulation of the immune system.
These are, however, only a few of many techniques that may have cyberphysiologic
consequences, for therapeutic intervention in the treatment of illness, and for education as
a form of self-development.
HYPNOSIS
Once thought of as magical or mysterious, hypnosis is rapidly becoming accepted as an
appropriate form of treatment for numerous disorders. Some primary care physicians are
beginning to discover the value of hypnotherapy in controlling chronic disease and pain,
in changing negative behavior, and in facilitating self-regulation of autonomic responses.
A useful definition put forward by Karen N. Olness, Professor of Pediatrics at Case
Western Reserve University, is that hypnosis is an alternative state of awarenessoften
but not always involving relaxationin which an individual develops heightened
concentration, which allows him to accept suggestions to use mental or physical faculties
in an optimal fashion to solve a problem, improve a skill, or maximize some potential.
The hypnotic state may best be described, she says, as effectively analogous to
pretending, daydreaming, imagining, or to being fully absorbed in some activity, such as
reading a good book, watching a TV program, or attending a concert. Fixed attention,
imagery, and concentration on an image with its associated feelings are factors in formal
hypnotic induction. Parents unwittingly learn this in getting a tired child to fall asleep.
Some of the more successful teachers, coaches, and salespersons may stumble on this
phenomenon by fine-tuning their respective approaches to dealing successfully with
people. It is also common for people to drop into this state automatically at peak
moments, such as a birth or wedding, or in states of high anxiety.
The hypnotherapist, Olness points out, possesses no special powers. Instead, the patient is
actually the self-hypnotizer, while the role of the one inducing the trance is that of coach
or guide.
Olness has had extensive experience in conducting experiments with children, whom she
has found learn cyberphysiologic techniques of self-hypnosis faster than adolescents and
adults, chiefly because young children are more in touch with their inner lives and have
more active imaginations. Controlled studies by her and her colleagues have
demonstrated that children are able to regulate peripheral temperature, auditory evoked
potentials, bronchial dilatation, transcutaneous oxygen flow, cardiac rate, and anorectal
sphincter responses. In clinical practice, she has found self-hypnosis useful as a
therapeutic modality in a variety of problems, including enuresis, acute pain, chronic
pain, asthma, habit disorders, and anxiety.
Other researchers have had similar results. In one of the more interesting studies reported
in the literature, Surman, Gottlieb, Hackett, and Silverberg, at the Massachusetts General
Hospital, showed that warts, although thought to be viral in origin, could be suggested
away under hypnosis. Surman and other colleagues have also been experimenting with
hypnosis, in conjunction with supportive psychotherapy, in an attempt to control the
clinical course of herpes simplex virus in severely affected individuals, since herpes has
been shown previously to recur under stress. Thus, experimental and clinical evidence for
the efficacy of hypnosis suggests that it has many potential uses in a medical setting.
BIOFEEDBACK
Biofeedback involves the mechanical or electrical recording of physiological processes,
usually heart rate, internal body temperature, brain wave activity, respiration, blood
pressure, or muscle tension, and the feeding back of this information to the subject, who
is then able, with appropriate instruction and motivation, to self-regulate these activities.
One of the most extensive programs of biofeedback research has been conducted at the
Menninger Foundation in Topeka, Kansas, by Elmer and Alyce Green. Subjects have
been successfully trained to reduce striate muscle tension, to show control over the firing
of single muscle units, and to raise the temperature in the hands through vasodilation of
the smooth muscle tissue surrounding the capillaries.
In clinical applications, biofeedback has proved helpful as an adjunct in the treatment of
Reynaud's disease, in the control of cardiac arrthymias, high blood pressure,
gastrointestinal disorders, tension headaches, epilepsy, and cerebral palsy.
One of the most interesting innovations in modem biofeedback technology that may
significantly influence our standard of normal health is voluntary cardiorespiratory
synchronization (VCRS), first developed by John Almasi, along with Otto Schmitt of the
University of Minnesota. Subjects are taught to synchronize their breathing and heart rate
to a predetermined ratio by a system of lights linked to the subject's body signals and sent
through a computer. Virtually all variability in the continuously produced
electrocardiogram signal is eliminated, whereas in normal ECG recordings the exact
shape and amplitude of the electrocardiographic signatures will change significantly from
beat to beat.
Initial tests in over 200 individuals, including university staff, students, and hospital
patients, have established that VCRS can be quickly and easily achieved by almost any
cooperative individual. After as little as 30 seconds of practice, the subject breathes
comfortably and accurately at a pace regulated by his electronic Inhale/Exhale instruction
lights.
given 6 months' yoga training showed a statistically significant drop in both systolic and
diastolic pressure, while those on antihypertensive medication showed a significant
reduction in daily drug dosage. A group of untrained males taught yoga exercises for a 4month period showed enhanced coagulation of blood as per specific variables, such as
fibrinolytic activity, blood and plasma level, and platelet aggregation time. After yoga
training, patients with pleural effusion were able to expand their lungs more quickly than
a comparable control group. Yoga, in general, is being more widely practiced in the
United States, not simply as a form of therapeutic intervention, but also as a daily regime
for the maintenance of good health.
MEDITATION
Meditation means sustained and effortless vigilance of one's own consciousness, with a
view toward enhancing the quality of personal experience. This may involve a specific
focus on cognitive processes, or a single idea, or it may involve the attempt to achieve a
noncognitive but heightened awareness where the mind is deliberately taught to empty
itself of all thought.
Deikman has identified meditation as deautomatizationa perceptual reorganization of
the psychological structures that order, limit, select, and interpret physical stimuli. He
defined it as an undoing of the ongoing process of unconscious habit formation, by
reinvesting actions and percepts with attention. In his experimental subjects he noted
alteration of perception, time underestimation, paradoxical thoughts, desensitization to
external stimulation, and personal attachment to the object of concentration.
Kamiya, noting that alpha brain waves are associated with meditation, used the
electroencephalograph to teach college students who had no experience in personal
disciplines to generate alpha waves and to sustain them over long periods.
Brown and Engler used questionnaires and Rorschach responses to compare three groups
of meditators, all of whom had training in Vipassana, or Buddhist "insight" meditation: a
mixed group of Western meditators with different levels of experience who were
attending a month long intensive training session, a selected group of advanced Western
meditators, and a group of advanced teachers in Asia. Results tended to corroborate that
meditation induces definable stages of change in the subjective experience of
consciousness, which initially are temporary, but may lead to permanent alteration of
personality. Epstein and Leiff have defined these stages: (1) Distraction of awareness by
somatic, affective, and cognitive disturbances; (2) transient, undisturbed concentration on
an internal object; (3) single-minded cultivation of concentration on the object; and (4)
the production of insight into the object and into one's own cognitive processes.
Studies also suggest that cognitive context leads to measurable differences in the
meditative state. Bal K. Anand of the All India Institute of Medical Sciences,
demonstrated that advanced yogis in deep meditation showed no alpha-blocking when
presented with a series of disturbing outside stimuli, whereas the startle response usually
blocks alpha production in normal subjects. This effect is commensurate with the goal of
Studies also suggest that natural killer cell activity (NK)- components of the body's
immune system that can target and destroy cancer and virus cells may be influenced
through psychological techniques. Scardino has reported increase in NK cell number
following relaxation and imagery exercises, and Cou-sins has reported the same effect
after self-induction of strong positive emotion. At the same time, Locke has found that
good copers, that is, individuals characterized by high stress who did not report many
symptoms or complaints, show high levels of natural killer cell activity, as compared
with those who are under high stress but who complain a great deal, whose NK levels
were significantly lower.
Other experiments, conducted by David McClelland and colleagues at Harvard
University, have linked high need for power with excessive adrenalin release, lowered
salivary and serum immunocompetence, and greater susceptibility to infection,
particularly when their subjects were highly motivated for power but blocked in their
efforts to dominate their environment. Using films to stimulate various psychological
states, McClelland and Kirshnit also showed that salivary immunoglobulin A (S-IgA), a
B-cell mediated function of the immune systemthe body's first line of defense against
viral infections that enter through the nose and mouthrose among college students
exposed to a film about Mother Teresa of Calcutta, whereas there was no comparable rise
in S-IgA levels among students exposed to a film about the triumph of the Nazi in World
War II.
What the precise mechanism of action is between
mental states and. immune competence has not
been definitely established. It has long been held
that the immune system operates in relative
independence from fluctuations of
electrochemical activity and hormone secretion,
chiefly because immune function can be
demonstrated for specific cells of this system in a
test tube, independent of the internal environment
of the tissues. However, scientists presently are
busy mapping out previously unrecognized lines
of interconnection between nerves, hormones, and
immune cells. This search involves not only the
laying out of direct neuronal connections to such
areas as the bone marrow, the spleen, and the
lymph glands, where synaptic circuits can be
anatomically traced, but also an entirely new
avenue of communication between the brain and
body through the action of the neuropeptides.
Francis Schmitt, a neurobiologist at the
Massachusetts Institute of Technology, has
proposed the hypothesis that neurons may be
functionally regulated not only by presently
known neurotransmitters but by many other kinds
of informational substances, which include
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CYBERPHYSIOLOGY:
The Science of Self-Regulation
No. 2 in a series, Time, Mind, and Medicine
No. 1: CHRONOBIOLOGY: A Science in Tune with the Rhythms of Life (1986)
writing
Eugene Taylor
Associate in Psychiatry, Harvard Medical School, Harvard University; Consultant in the History of
Psychiatry, Massachusetts General Hospital
We would like to thank all the authors and publishers who have given us permission to reproduce their text
quotations and illustrations. Most of all we would like to acknowledge the assistance of our advisors:
Stephen E. Locke, M.D.
Herbert Benson, M.D.
Karen N. Olness, M.D.
David C. McClelland, Ph.D.
Francis O. Schmitt, Ph.D.
Otto Marx, M.D.
for ARCHAEUS PROJECT:
Editor
Dennis Stillings
Mnaging Edtor
Gail Duke
Dsign
Cathryn Stewart